WO2013000536A1 - Système de trocart - Google Patents

Système de trocart Download PDF

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Publication number
WO2013000536A1
WO2013000536A1 PCT/EP2012/002353 EP2012002353W WO2013000536A1 WO 2013000536 A1 WO2013000536 A1 WO 2013000536A1 EP 2012002353 W EP2012002353 W EP 2012002353W WO 2013000536 A1 WO2013000536 A1 WO 2013000536A1
Authority
WO
WIPO (PCT)
Prior art keywords
trocar
working channel
working
channel
trocar system
Prior art date
Application number
PCT/EP2012/002353
Other languages
German (de)
English (en)
Inventor
Siegfried Riek
Karl-Heinz Bachmann
Thomas Gaiselmann
Original Assignee
Siegfried Riek
Karl-Heinz Bachmann
Thomas Gaiselmann
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by Siegfried Riek, Karl-Heinz Bachmann, Thomas Gaiselmann filed Critical Siegfried Riek
Priority to US14/129,881 priority Critical patent/US20140128671A1/en
Priority to EP12735776.2A priority patent/EP2725962B1/fr
Publication of WO2013000536A1 publication Critical patent/WO2013000536A1/fr

Links

Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B1/00—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor
    • A61B1/012—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor characterised by internal passages or accessories therefor
    • A61B1/018—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor characterised by internal passages or accessories therefor for receiving instruments
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B1/00—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor
    • A61B1/00147—Holding or positioning arrangements
    • A61B1/00154—Holding or positioning arrangements using guiding arrangements for insertion
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B1/00—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor
    • A61B1/012—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor characterised by internal passages or accessories therefor
    • A61B1/0125—Endoscope within endoscope
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B1/00—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor
    • A61B1/06—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor with illuminating arrangements
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B1/00—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor
    • A61B1/313—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor for introducing through surgical openings, e.g. laparoscopes
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/28—Surgical forceps
    • A61B17/29—Forceps for use in minimally invasive surgery
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/30—Surgical pincettes without pivotal connections
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/32—Surgical cutting instruments
    • A61B17/3201—Scissors
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/34—Trocars; Puncturing needles
    • A61B17/3417—Details of tips or shafts, e.g. grooves, expandable, bendable; Multiple coaxial sliding cannulas, e.g. for dilating
    • A61B17/3421—Cannulas
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/34—Trocars; Puncturing needles
    • A61B17/3417—Details of tips or shafts, e.g. grooves, expandable, bendable; Multiple coaxial sliding cannulas, e.g. for dilating
    • A61B17/3421—Cannulas
    • A61B17/3423—Access ports, e.g. toroid shape introducers for instruments or hands
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/34—Trocars; Puncturing needles
    • A61B17/3474—Insufflating needles, e.g. Veress needles
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/34—Trocars; Puncturing needles
    • A61B17/3478—Endoscopic needles, e.g. for infusion
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B1/00—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor
    • A61B1/04—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor combined with photographic or television appliances
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B2017/00831—Material properties
    • A61B2017/00902—Material properties transparent or translucent
    • A61B2017/00907—Material properties transparent or translucent for light
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/34—Trocars; Puncturing needles
    • A61B17/3417—Details of tips or shafts, e.g. grooves, expandable, bendable; Multiple coaxial sliding cannulas, e.g. for dilating
    • A61B17/3421—Cannulas
    • A61B2017/3445—Cannulas used as instrument channel for multiple instruments
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/34—Trocars; Puncturing needles
    • A61B17/3417—Details of tips or shafts, e.g. grooves, expandable, bendable; Multiple coaxial sliding cannulas, e.g. for dilating
    • A61B2017/3454—Details of tips
    • A61B2017/3456—Details of tips blunt
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
    • A61B90/30—Devices for illuminating a surgical field, the devices having an interrelation with other surgical devices or with a surgical procedure
    • A61B2090/306—Devices for illuminating a surgical field, the devices having an interrelation with other surgical devices or with a surgical procedure using optical fibres
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
    • A61B90/36—Image-producing devices or illumination devices not otherwise provided for
    • A61B90/361—Image-producing devices, e.g. surgical cameras

Definitions

  • the invention relates to a trocar system according to the preamble of patent claim 1.
  • Trocars for minimally invasive surgery typically consist of a trocar to create an opening in a body cavity (eg, abdominal cavity) and a trocar sleeve that remains in that opening and provides access to the interior of the body cavity for surgical intervention ,
  • the trocar has a distal tip which is used to penetrate the body tissue, e.g. the building ceiling, serves to create the opening.
  • the tip of the trocar may be formed sharp, cutting or blunt.
  • a sharp point has the shape of a triangular pyramid.
  • Cutting tips have a blade that creates a tissue that is subsequently dilated by the conical tip. Blunt tips are rounded off distally, so that very high penetration pressures are necessary for the opening of the tissue layers. Thereafter, these essentially cause only a dilatation of a previously generated lesion.
  • the distal tip is formed as a hollow transparent cone, from the inside through an optic
  • CONFIRMATION COPY is observable, which is received in a coaxially extending in the Trokardorn optical channel.
  • the optical trocar provides a three-dimensional view of the tissue layers of the abdominal wall, through which the tip of the trocar passes. This gives the surgeon a sense of movement, speed and position of the trocar tip during penetration. In particular, it can be recognized before the penetration of the peritoneum whether adhesions between the intestine and the peritoneum are present at the insertion site. The high penetration pressures remain at the penetration of the fascia and the peritoneum. Although these penetration pressures could be reduced by cutting blades at the trocar tip, this in turn would increase the risk of injury to the intestine upon penetration.
  • the abdominal wall is prepared in the classical manner with a scalpel via a skin incision and then a trocar sleeve inserted into the opened peritoneum.
  • the problem is the sealing of the pneumoperitoneum, since the resulting opening in the abdominal wall is larger than would be the case with a trocar puncture.
  • the open incision of the abdominal wall contradicts the objective of the minimally invasive surgical technique.
  • the invention is based on the object of providing a trocar system which exploits the advantages of the optical trocar without requiring high pressures during tissue penetration.
  • the essential idea of the invention is to use the trocar not only as a passive tool which manually by an axial force and optionally by a
  • the trocar can be associated with various active surgical instruments that can be passed through at least one working channel formed in the trocar and extended at the distal tip of the trocar.
  • various active surgical instruments can be passed through at least one working channel formed in the trocar and extended at the distal tip of the trocar.
  • a miniaturized scissors or a knife can be extended out of the distal trocar tip in order to sever or cut the respective tissue layer in front of the distal tip.
  • the resistant tissue layers such as the fascia and the peritonemum can be opened in this way under view through a small incision, so that subsequently the tip of the trocar can penetrate into this incision and dilate without intense pressure and especially without tenting the incision and penetrate the tissue layer can.
  • the visualized tissue layers respectively adjacent to the distal tip of the trocar can thus be prepared in order to allow a nearly pressureless and thus risk-free penetration of the tissue layers.
  • the semitransparency of the per-lemonum allows the penetration of the optical trocar to detect adhesions before opening. This is not possible with the open laparotomy.
  • tweezers or forceps can be passed through the working channels to hold the tissue to the distal trocar tip, which may be particularly advantageous for incision by means of a scissors or blade inserted through another working channel.
  • clamps or coagulation instruments can be passed through the working channels and extended at the distal tip. With these instruments vessels can be clamped or coagulated.
  • miniaturized morcellators can also be extended beyond the distal tip.
  • a miniaturized digital camera through a working channel, e.g. to document the surgical procedure from a different perspective. It can also be performed light guides for additional lighting through a working channel.
  • the trocar system according to the invention thus enables the penetration, in particular of the abdominal wall, for which purpose, for example, the trocar is inserted until its distal tip reaches the fascia.
  • a clamp is extended, which holds the fascia, while extended by a different working channel a pair of scissors, which opens the Fascie. This is done under the sight through the transparent tip of the trocar.
  • the tip of the trocar is now inserted into the generated opening of the fascia, the further dilatation is atraumatic with low penetration pressure.
  • the trocar tip reaches the peritoneum, a respiratory-synchronous displacement of the intestine reveals that there are no adhesions, whereupon the peritoneum can be opened in a corresponding manner by means of scissors and, if appropriate, a clamp. The tip of the trocar is then inserted into the created opening of the peritoneum. Also here is no significant penetration pressure; necessary so that the tending effect and its risks are avoided.
  • This procedure is analogous to the usual preparative steps in open laparotomy. In contrast to this known preparative procedure, however, no larger incision is necessary than is necessary for the introduction of the trocar.
  • a Veress needle can also be extended through a working channel, with which the peritoneum is then penetrated under view, in order then to insufflate C0 2 into the abdomen.
  • the Veressnadel is withdrawn and the tip of the trocar is introduced into the opening formed by the Veressnadel to dilatationally atraumatic pressure under low pressure.
  • a trocar sleeve can be inserted by means of the trocar, which then serves as an access channel for the subsequent minimally invasive procedure. It is also possible to carry out a single-port operation by means of the trocar system without setting a trocar sleeve z. In this case, the trocar with the opti and the working channels remains as the only access for the subsequent minimally invasive procedure, with the instruments being introduced for engagement by the working channels.
  • the instruments which can be used with the trocar system according to the invention are essentially miniature surgical instruments known per se. These have a working element which can be extended at the distal tip of the trocar mandrel, while the proximal actuation elements of the miniature instrument are arranged at the end remaining proximally outside the working channel.
  • the instruments may be formed with a rigid or a flexible shaft. For flexible instru It is possible to bias these elastically so that their distal working elements bend against the central axis of the trocar as they emerge from the distal tip of the trocar to allow preparative work immediately in front of the transparent tip.
  • a guide tube may be arranged to be axially displaceable and rotatable, through which the miniature instrument is performed.
  • the guide tube is resiliently biased in its distal end portion to bend.
  • the guide tube consists of a memory alloy with superelastic properties, eg. From nitinol.
  • the working channels may be closable proximally by a valve when no instrument is in the working channel.
  • a valve may in particular be formed by a lip seal known per se, which allows a passage of an instrument and seals an inserted instrument on its outer periphery.
  • unused working channels can be closed by a stylet, which closes the distal outlet opening of the working channel, so that in particular contamination of the working channel is avoided.
  • the trocar may have a coaxial optical channel enclosing massive wall in which the working channels as axially parallel through holes . are formed.
  • the trocar may be formed with a double wall, which forms a hollow annular gap.
  • the working channels are arranged as axially parallel tubes. With sufficient radial space, the working channels can also be used as a tube on the inner or outer surface of the
  • the number of working channels is determined by the intended use. In the simplest case, only one working channel is available. Preferably, however, two or three working channels are provided at the same mutual angular distance.
  • the distal outlet openings of the working channels can be arranged in the same axial position in the lateral surface of the distal tip of the trocar. It is also possible that the working channels open distally in different axial position at the tip of the trocar.
  • the working channels are substantially parallel to the axis in the trocar or even at an angle to the instrument axis or helically around the instrument axis. At the proximal end, they can enter at an angle to the trocar axis
  • An angled entry end may facilitate insertion and handling of the miniature instrument, if desired.
  • An angled exit end may be positioning facilitate the working element of the miniature instrument, especially when this is elastically biased to bending.
  • the inlet opening and the outlet opening of the working channel need not necessarily be arranged at the proximal or distal end of the trocar, but may also be arranged offset axially against the ends of the trocar.
  • a new application can find the trocar system according to the invention in mammoplasty.
  • Tumors or lymph nodes can be visualized under view e.g. be approached by a cosmetically favorable Mamil- lenrandrough.
  • all the necessary surgical instruments can be used via the working channels.
  • This single-port technique in which the trocar is also used to supply the instruments for the actual surgical use, is particularly advantageous from a cosmetic point of view, since only a single incision is required.
  • a CU2 insufflation can be performed via a working channel in order to generate an expanded space, so that the preparative operation can take place in a non-preformed tissue cavity.
  • the entire procedure can take place under the view through the distal tip of the trocar so that an exact and complete dissection and removal of a tumor is possible.
  • All known surgical instruments and surgical techniques may be used, e.g. Knives, punches, coagulation instruments, morcellators, optics, light guides, lighting systems and the like.
  • FIG. 1 shows an axial section through a trocar system
  • Fig. 2 is a section along the line AA in Figure 1 and
  • Fig. 3 is a figure 2 corresponding section of a modified embodiment.
  • the trocar system has a trocar 10.
  • the trocar mandrel 10 is in the form of a rigid elongated cylindrical tube made of metal or plastic.
  • the inner lumen of the trocar horn 10 forms an optic channel 12 coaxial from the proximal end to the distal end.
  • the distal tip 14 of the trocar larynx 10 has the shape of a cone with a rounded blunt tip. If necessary, the conical surface can also be convex.
  • the conical tip 14 is hollow inside and consists of a thin-walled transparent material, in particular of a transparent plastic.
  • In the optical channel 12 of the trocar dart optics 16 can be used, which may be formed in particular as a rod lens optics or with a camera chip and may have integrated a lighting system.
  • the distal tip 14 When inserted optics 16 whose distal end is approximately in the region of the base surface of the conical tip 14. By the optics 16, the distal tip 14 can be illuminated from the inside and observed. As a result, it is possible to observe tissue lying on the outside of the distal tip 14.
  • the trocar system corresponds to a per se known optical trocar. Variations as known from optical trocars are also possible and usable in the invention.
  • At least one working channel 20 is provided in the optical channel 12 enclosing wall 18 of the trocar 10.
  • two diametrically opposed the arranged working channels 20 are provided.
  • Other versions with three or more working channels 20 are possible, which are then preferably offset from one another at the same angular distance from each other about the optical channel 12 around.
  • the working channels 20 run in the wall 18 of the trocar mandrel 10 continuously from proximal to distal.
  • the working channels 20 are formed as holes in the solid wall 18.
  • the wall 18 may also be formed by two coaxial sleeve-like tubes, in whose circular cylindrical free space the working channels 20 are arranged as thin tubes. If the inner diameter of the optical channel 12 is greater than the diameter of the optical system 16 to be used, the working channels 20 can also be attached as a tube to the inner lateral surface of the wall 18. If the outer diameter of the trocar mandrel 10 is smaller than the inner diameter of a trocar sleeve used, then the working channels 20 can also be attached as tubes to the outside of the outer circumferential surface of the wall 18.
  • the trocar 10 may in particular also be made of plastic.
  • the working channels 20 can be produced during casting of the plastic or be encapsulated as a tube with the plastic. If the trocar is made of a transparent plastic, the working channels 20 and a miniature instrument introduced into the working channel 20 can be observed from the outside.
  • the trocar 10 may have an outer diameter of
  • the working channels 20 are preferably sealed by a valve 22, which closes the proximal end of the respective working channel 20 in a gastight manner when the working channel 20 is empty, and which permits a sealed passage of an instrument.
  • a valve 22 may be formed in a conventional manner, for example as a lip seal or the like.
  • the working channels 20 generally run parallel to the axis in the wall 18 of the trocar mandrel 10. At the proximal end, the working channels 20 may also be angled outwardly towards the central axis of the trocar mandrel 10. Likewise, the working channels 20 may be bent at its distal end against the axis of the trocar 10 to the outside. At the distal end, the working channels 20 open with an open outlet opening 24 in the region of the distal tip 14. The outlet openings 24 can be located in the same axial position with respect to the longitudinal extent of the trocar 10, as shown in FIG.
  • outlet openings 24 of the various working channels 20 are offset from one another in their axial position, so that the outlet opening 24 of a working channel 20 opens more distally at the tip 14 than the other outlet opening 24, for example, also proximally behind the tip 14 may lie.
  • each miniature instruments 26 can be introduced, as shown in Figure 1 for the lower working channel 20, for example.
  • the miniature instruments 26 are arbitrary instruments corresponding to the respective application, as they are known per se.
  • the miniature instruments 26 have an elongated shaft 28, at the distal end of which a working element 30 is connected. is ordered, which can be actuated by means of an arranged at the proximal end of the shaft 28 actuator 32.
  • a miniature scissors is shown only as an example, the working element 30 is formed as a pair of scissors, while its actuator 32 is a scissor handle.
  • the miniature instrument 26 is inserted from the proximal end into the working channel 20, passing through the valve 22 and being circumferentially sealed therethrough.
  • the miniature instrument 26 can be advanced in the working channel 20 until the distal working element 30 is extended through the outlet opening 24 and can be used in front of the distal tip 14.
  • Miniature instruments 26 are known in a rigid, flexible and semi-flexible design.
  • the miniature instruments 26 may in particular also be designed with an elastically preloaded shaft curvature. As a result, the distal working element 30 deviates from the axial direction of the working channel 20 when the distal working element emerges from the outlet opening 24. This allows a targeted positioning of the working element 30 during use.
  • a guide tube can be used in the working channel 20, which can be moved axially in the working channel and rotated.
  • the guide tube consists of a memory alloy with so-called super-elastic properties, eg. From nitinol.
  • the guide tube is biased to curvature at least in its distal end region.
  • the direction of the distal end of the guide tube can be rotated about the axis. If the miniature instrument 26 is guided through the guide tube, the outlet direction of the working element 30 can be controlled three-dimensionally by axial displacement and rotation of the guide tube.
  • actuators are provided which move axially and rotationally. allow the guide tube.
  • a stylet not shown in the drawing, which with its distal end closes the outlet opening 24 flush with the surface so as to prevent contaminants from entering the unused working channel 20, can be inserted into an unused working channel 20.
  • the trocar system may also have a trocar sleeve pushed onto this trocar 10.
  • Fabric layers e.g. the abdominal wall are penetrated by means of the trocar mandrel 10, the trocar sleeve seated on the trocar mandrel 10 being introduced into the generated body opening.
  • the trocar sleeve After withdrawal of the trocar 10, the trocar sleeve remains as access to the body cavity.
  • the trocar 10 can be used without trocar as a single port.
  • the trocar horn 10 After penetration, the trocar horn 10 remains in the created body opening and the operation in the body cavity is performed under the sight of the transparent distal tip 14 by means of miniature instruments inserted through the working channels 20. LIST OF REFERENCE NUMBERS

Abstract

L'invention concerne un système de trocart comportant une tige de trocart (10) présentant un canal optique (12) s'étendant coaxialement dans la tige de trocart (10) pour recevoir une optique (16), et une pointe distale (14) transparente et creuse de la tige de trocart (10), pouvant être observée par l'intérieur au moyen de l'optique (16). La paroi (18) de la tige de trocart (10) entourant le canal optique (12) comporte au moins un canal de travail (20) menant, de façon traversante et parallèle à l'axe, de l'extrémité proximale de la tige de trocart (10) jusque dans sa pointe distale (14), et aboutissant au niveau de la pointe (14) dans une ouverture de sortie (24).
PCT/EP2012/002353 2011-06-30 2012-06-04 Système de trocart WO2013000536A1 (fr)

Priority Applications (2)

Application Number Priority Date Filing Date Title
US14/129,881 US20140128671A1 (en) 2011-06-30 2012-06-04 Trocar System
EP12735776.2A EP2725962B1 (fr) 2011-06-30 2012-06-04 Système de trocart

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
DE102011107612A DE102011107612A1 (de) 2011-06-30 2011-06-30 Trokarsystem
DE102011107612.7 2011-06-30

Publications (1)

Publication Number Publication Date
WO2013000536A1 true WO2013000536A1 (fr) 2013-01-03

Family

ID=46516662

Family Applications (1)

Application Number Title Priority Date Filing Date
PCT/EP2012/002353 WO2013000536A1 (fr) 2011-06-30 2012-06-04 Système de trocart

Country Status (4)

Country Link
US (1) US20140128671A1 (fr)
EP (1) EP2725962B1 (fr)
DE (1) DE102011107612A1 (fr)
WO (1) WO2013000536A1 (fr)

Cited By (5)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
WO2013135354A3 (fr) * 2012-03-13 2014-05-08 Siegfried Riek Système de trocart
CN109222857A (zh) * 2018-09-28 2019-01-18 中国人民解放军第四军医大学 一种可变径脑部造瘘神经内镜工作通道
US10426496B2 (en) 2013-08-15 2019-10-01 Thomas Gaiselmann Method for surgically removing a tumor from a woman's breast
USD935611S1 (en) 2018-12-10 2021-11-09 Pneumonix Medical, Inc. Tissue tract sealant device
US11638578B2 (en) 2017-11-28 2023-05-02 Pneumonix Medical, Inc. Apparatus and method to seal a tissue tract

Families Citing this family (14)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
DE102011107613A1 (de) * 2011-06-30 2013-01-03 Siegfried Riek Trokarsystem
JP5932994B2 (ja) * 2012-05-25 2016-06-08 富士フイルム株式会社 内視鏡手術装置及び外套管
US10064695B2 (en) * 2013-02-26 2018-09-04 The General Hospital Corporation Systems for abdominal wall lifting and needle insertion
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US20140128671A1 (en) 2014-05-08
EP2725962B1 (fr) 2020-07-29
EP2725962A1 (fr) 2014-05-07

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